Madhukar Pai

Université McGill

Domaine : Maladies infectieuses et immunitaires

Project abstract

Tuberculosis is still a severe global public health threat: a third of the world¿s population is infected with tuberculosis, and 9 million new cases and 2 million deaths occur each year. Early diagnosis and prompt treatment are keys to controlling and eliminating tuberculosis. Unfortunately, current tests are old, slow and can¿t be used in resource-limited settings. Therefore, my current research program is to study new rapid tests for tuberculosis that can be used in clinics, without specialized laboratories.

The first project will evaluate performance and cost-effectiveness of a new test that can detect tuberculosis in less than 2 hours in a regular clinic, the Xpert MTB/RIF. Even though less and less Canadians are infected with tuberculosis, rates are high among certain immigrants and Aboriginal populations. Currently, Nunavut is facing its largest tuberculosis outbreak ever. Therefore, the Xpert will be evaluated in a hospital in Iqaluit, Nunavut, and in a tuberculosis clinic in Montreal, Quebec, and results will be compared to that of conventional tests for tuberculosis. This study will generate data that will enable government agencies to develop evidence-based Canadian guidelines on this novel test.

The second project is to develop the world¿s first simple test for extra-pulmonary tuberculosis that can be used in a regular clinic (point-of-care), for under $3. This test will be developed and validated in India, where tuberculosis is an important problem, with the help of 2 Indian institutions. With this new test, extra-pulmonary tuberculosis will be diagnosed in less than 20 minutes, without any specialized staff or laboratories. This study will provide data on the test¿s accuracy, performance and ease of use, and may lead to a second phase to conduct larger studies, with different forms of extra-pulmonary tuberculosis.